Weber R, Bryan R T, Schwartz D A, Owen R L
Department of Medicine, University Hospital, Zurich, Switzerland.
Clin Microbiol Rev. 1994 Oct;7(4):426-61. doi: 10.1128/CMR.7.4.426.
Microsporidia are obligate intracellular spore-forming protozoal parasites belonging to the phylum Microspora. Their host range is extensive, including most invertebrates and all classes of vertebrates. More than 100 microsporidial genera and almost 1,000 species have now been identified. Five genera (Enterocytozoon spp., Encephalitozoon spp., Septata spp., Pleistophora sp., and Nosema spp.) and unclassified microsporidia (referred to by the collective term Microsporidium) have been associated with human disease, which appears to manifest primarily in immunocompromised persons. The clinical manifestations of microsporidiosis are diverse and include intestinal, pulmonary, ocular, muscular, and renal disease. Among persons not infected with human immunodeficiency virus, ten cases of microsporidiosis have been documented. In human immunodeficiency virus-infected patients, on the other hand, over 400 cases of microsporidiosis have been identified, the majority attributed to Enterocytozoon bieneusi, an important cause of chronic diarrhea and wasting. Diagnosis of microsporidiosis currently depends on morphological demonstration of the organisms themselves. Initial detection of microsporidia by light microscopic examination of tissue sections and of more readily obtainable specimens such as stool, duodenal aspirates, urine, sputum, nasal discharge, bronchoalveolar lavage fluid, and conjunctival smears is now becoming routine practice. Definitive species identification is made by using the specific fluorescein-tagged antibody (immunofluorescence) technique or electron microscopy. Treatment options are limited, but symptomatic improvement of Enterocytozoon bieneusi infection may be achieved with the anthelmintic-antiprotozoal drug albendazole. Preliminary observations suggest that Septata intestinalis and Encephalitozoon infections may be cured with albendazole. Progress is being made with respect to in vitro propagation of microsporidia, which is crucial for developing antimicrosporidial drugs. Furthermore, molecular techniques are being developed for diagnostic purposes, taxonomic classification, and analysis of phylogenetic relationships of microsporidia.
微孢子虫是属于微孢子门的专性细胞内形成孢子的原生动物寄生虫。它们的宿主范围广泛，包括大多数无脊椎动物和所有脊椎动物类别。现已鉴定出100多个微孢子虫属和近1000个物种。五个属（肠微孢子虫属、脑微孢子虫属、Septata属、Pleistophora属和Nosema属）以及未分类的微孢子虫（统称为微孢子虫属）与人类疾病有关，这些疾病似乎主要在免疫功能低下的人群中表现出来。微孢子虫病的临床表现多种多样，包括肠道、肺部、眼部、肌肉和肾脏疾病。在未感染人类免疫缺陷病毒的人群中，已记录到10例微孢子虫病病例。另一方面，在感染人类免疫缺陷病毒的患者中，已鉴定出400多例微孢子虫病病例，其中大多数归因于肠微孢子虫，它是慢性腹泻和消瘦的一个重要原因。目前，微孢子虫病的诊断依赖于对病原体本身的形态学证明。通过光学显微镜检查组织切片以及更容易获得的标本（如粪便、十二指肠抽吸物、尿液、痰液、鼻分泌物、支气管肺泡灌洗液和结膜涂片）来初步检测微孢子虫，现在已成为常规做法。通过使用特异性荧光标记抗体（免疫荧光）技术或电子显微镜进行明确的物种鉴定。治疗选择有限，但使用抗蠕虫原虫药物阿苯达唑可使肠微孢子虫感染的症状得到改善。初步观察表明，阿苯达唑可能治愈Septata intestinalis和脑微孢子虫感染。在微孢子虫的体外繁殖方面正在取得进展，这对于开发抗微孢子虫药物至关重要。此外，正在开发分子技术用于诊断、分类学分类以及分析微孢子虫的系统发育关系。
